Customer experience

Gilsbar Inc. has had a detailed disaster recovery and business continuity plan in place since 1996. The New Orleans-based third-party administrator, which handles claims for about 150,000 members, employs a certified disaster recovery specialist. And, the company's executives and technical staff go through tabletop disaster recovery scenarios at least twice a year.Like many other insurance companies, Gilsbar is prepared for catastrophes. However, when Hurricane Katrina hit last year, insurance executives were caught by surprise and had to act on their feet and respond to a bevy of unexpected circumstances.

I'm sure you've heard the one about the life insurance salesman who asked his client, "Do you know the present value of your husband's life insurance policy?""What do you mean?" countered the woman.

In a sign of the major benefits to be won by insurance firms that accentuate Web-based and electronic solutions, the Blue Bell, Pa.-based insurer PMA Insurance Group received superlative ratings in customer service in a recent survey conducted by an independent researcher.In the survey, J.P. Murphy and Co., a Malvern, Pa.-based marketing and opinion research firm, asked approximately 500 of PMA's active clients about the quality of customer service that the insurer offered in areas including claims processing, risk assessment, risk management and cost control.

Despite reeling from the worst year in history for claims losses, pundits say the insurance industry plans to increase its spending on claims technology in 2006. For some, the idea of stepping up to new technology sounds like the perfect way to address inefficiencies that continue to plague claims processing. To others, it's yet another Band-Aid that may or may not be effective in solving what has become a hushed, off-the-record issue: claims leakage."Claims leakage is the difference between what you spent on a claim and what you should have spent," says one East Coast health insurance claims executive, who, like many sources interviewed for this story, asked to remain anonymous.

According to the coalition Against Insurance Fraud, insurance fraud is an $80-billion crime wave. Unfortunately, most insurance carriers have neither the processes nor technology they need to stop fraud.Even so, as fraud schemes become more sophisticated, insurance carriers must examine an even wider array of data to identify fraud trends and detect fraudulent claims. To do this, they must institute a set of technology best practices and techniques to automatically detect fraud and abuse early in the claims process.

Seoul, Korea - In what is being called the largest deal of its kind for the financial services industry in Korea, Kyobo Life Insurance has contracted IBM to operate and manage its IT infrastructure.Under the terms of the 10-year agreement which has a total contract value of approximately 340 million U.S. dollars, IBM will provide IT strategy consulting services to help develop and advance Kyobo's IT vision and strategy. IBM will also manage the company's servers, storage systems, network and desktop computers and operate its data and disaster recovery centers. Additionally, IBM will provide IT skills development and IT management training services, called 'IT University', for Kyobo's employees.

New York and Emeryville, Calif. - After the completion of a successful 18-month pilot, Empire Blue Cross Blue Shield and RelayHealth Corp. are expanding the RelayHealth webVisit service to all members of Empire's HMO plan.Beginning July 1, 2006 more than 400,000 HMO members will have access to RelayHealth's Web-enabled doctor visits. As part of the expansion agreement, Empire will also make RelayHealth available to all of its national Administrative Services Only (ASO) accounts as a new benefit.

New York City - The National Association of Insurance Commissioners (NAIC) has launched a comprehensive public education program to assist consumers with information about insurance issues.Under the banner of "Insure U," the campaign has two objectives: to help consumers get smart about insurance as their needs change at different life stages, and to educate them about how to avoid being scammed by fake insurance companies. The program includes an online education site and public service announcements in English and Spanish.

Okemos, Mich. - Sircon Corp. and Efficient Forms LLC, Littleton, Colo., have formed an exclusive partnership designed to build on each other's products and customer bases to create an online platform for agent hiring, contracting and licensing for insurance agents, carriers and regulators. The partnership is a step toward creating a single online community where insurance carriers and their distribution partners can collaborate through an integrated, coordinated network, according to the two companies."This combination provides online capabilities that can transform processes between insurance carriers and their distributors," says Gary Gummig, vice president of business development at Sircon. "By integrating online services that will automate transactions and workflow, and virtually eliminate paperwork, this creates opportunity for unprecedented process breakthroughs."

Bettendorf, Iowa and Edison, N.J. - Fraud Resource Group, a business, insurance and identity fraud investigative and consulting firm, is using StrikeForce Technologies' products to launch a Web-based identity validation and authentication service, called the Trusted Customer program, which is designed to help prevent fraudsters from setting up fraudulent accounts and stealing high-value vehicles, goods and rental equipment.Construction equipment theft is a $1 billion annual problem, according to the National Insurance Crime Bureau, and only 10% to 15% of stolen equipment is ever recovered, according to the National Equipment Register. Fraudsters, posing as customers and contractors, use false credentials and stolen credit card data to "rent" vehicles, tools, and construction equipment. The rental stores lose equipment and potential income until a replacement arrives, and the legitimate credit card holder is left to dispute the charge.